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1、MicrowaveAblationForChronicAtrialFibrillationLiPoa,M.D.,F.A.C.S.DirectorofPerioperativeServicesEnloeMedicalCenterChico,CaliforniaTheFutureofCardiacIntervention(NationalHealthCouncil)Stentandintravascularinterventionexpectedtodoubleovernext3yearsCABGvolumetodeclineabout10%withc
2、ardiacsurgeryprimarilyexpandinginEPSandCHFsuchasablativesurgery,biventricularpacing,LVremodeling,andcardiacmuscleaugmentation.Valvularvolumetoincreaseabout20%by2005ChronicAtrialFibrillationAffects2millionpeopleintheUSalonewitha9%5yearmorbidityfromanticoagulationanda5%/yearrisk
3、ofstrokeAshighasan80%riskofstrokeat8yearsintheJapanesestudygroup(Kitamura)Availabletreatmentmodalitiesincludesurgical“Maze”,cryotherapy,radiofrequency,irrigatingradiofrequency,microwave,andlaserSurgicalMazesuccessbestoverallbutMicrowavehastheleastcomplicationsandthebesteaseofu
4、seMicrowaveAblation:~3000patientsOpenHeart2300patients75%success-0to4yearfollowupBeatingHeart–Off-Pump700patients80%success-0to2yearfollowupNoadverseeventsMIS–Off-PumpMiniThoracotomy3casesRobotic2casesThoracoscopy2cases2cm-FLEX2TM4cm-FLEX4TM7cm-FLEX7“...specimenswerecharacteri
5、zedbymyocellulardamageinvolvingthefullthicknessoftheatrialwall,wherethicknessrangedfrom4-5mmto1cm.”ClinicalHistopathologyandUltrastructuralAnalysisofMyocardiumfollowingMicrowaveEnergyAblationEricManasseMD,PiergiuseppeColomboMD,PaolaBraidottiPhD,MassimoRoncalliMD-PhD,RobertoGal
6、lottiMD(submittedtotheAnnalsofTh.Surg.)from:InVitroandInVivoEvaluationoftheThermalPatternsandLesionsofCatheterAblationwithaMicrowaveMonopoleAntennaDavidKeaneMD,Ph.D.,JeremyRuskinMD,NancyNorris,Pierre-AntoineChapelon,DanyBerube,Ph.D.Beating-HeartSurgeryEpicardialablationEndocar
7、dialviewTransmuralLesionViableTissueBeating-HeartSurgeryDr.Maessen-Maastricht,Netherlands(Off-pump)40patients(32cAF,8pAF)acutedischargeFU40/4026/3932/39(82%)10patients8-11months10patients6-8months19patients0-6monthsPresentedatISMICS-2002n=31(mitralvalve)26/31(84%)insinusrhythm
8、Dr.Zembala-Zabrze,Poland(ArrestedHeart)PresentedatCTT-200229p
